Recommendations for immediate care of the soft tissue injuries include cleaning the area surrounding the wound and the wound itself. Practices vary somewhat in the selection of and use of the cleansing agent for cleansing the skin and the wound. The use of detergents of surfactants for wound cleaning, outside of a very few exceptions are ordinarily avoided because of their harmful effects on wound healing. In other words, despite the fact that many detergents are highly effective cleaning agents and do an excellent job in removing foreign substances from a wound they are nevertheless "toxic" in the sense that they impair the wound's tissue's ability to resist infection. Of special note is the fact that other standards or measurements of toxicity, for instance, oral toxicity, intravenous toxicity and skin sensitivity have not been found to bear a direct relationship to the ability of a detergent to impair a wound's ability to resist infection. A number of detergents acknowledged or classed as non-toxic on the basis of other studies unfortunately prove toxic to wound healing, that is, do in fact impair the wound's ability to resist infection.
Among the commercially available surgical scrub solutions which have been used by surgeons are pHisoHex and Betadine. The harmful effects of even these solutions have been reported and confirmed by studies in Custer, J., Edlich, R. F., Prusak, M. Madden, J., Panek and Wangensteen, O. H. "Studies in the management of the contaminated wound V. An assessment of the effectiveness of pHisoHex and Betadine surgical scrub solutions." Amer. J. Surg. 121:572, 1971. These surgical scrub solutions are mixtures of an antiseptic agent and a surface active detergent, the antiseptic agent being employed to destroy the viable bacteria in the wound while the surface active agent is utilized as a cleansing agent to remove foreign bodies from the wound surface. It was found that treatment of the contaminated wounds in guinea pigs with either of these surgical scrub solutions increased the wound's susceptibility to bacterial infection. In fact, the incidence of infection after treatment of the contaminated wounds with these surgical scrub solutions was higher than the infection rate of wounds subjected to 0.9% sodium chloride solution. The antiseptic agents in the surgical solutions while exerting a favorable influence on contaminated wounds fails to eliminate the harmful effect of the detergents.
As a consequence of the increasing evidence on the harmful effects of detergents on wounds, most surgeons today simply irrigate the wound with large amounts of 0.9% sodium chloride solution.
Needless to say a need exists in the cleansing of contaminated wounds for a cleaning agent which possesses the desired effective cleansing action without the adverse effects on wound healing that characterize prior art detergent-containing surgical scrubs. It is one object of the invention, therefore, to satisfy this need. Another object of the invention is to provide a new detergent-containing surgical scrub solution which provides antiseptic benefits without impairment to wound healing.